Healthcare Provider Details

I. General information

NPI: 1790610913
Provider Name (Legal Business Name): THRIVEWELL HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 W 15TH ST
WASHINGTON NC
27889-3591
US

IV. Provider business mailing address

2005 W 15TH ST
WASHINGTON NC
27889-3591
US

V. Phone/Fax

Practice location:
  • Phone: 252-833-5245
  • Fax: 252-833-5244
Mailing address:
  • Phone: 252-833-5245
  • Fax: 252-833-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. STEPHANIE MILLS WYNN
Title or Position: OWNER
Credential: FNP-C
Phone: 252-833-5245